Scope of nurse led clinic in oncology

1. Scope of Nurse Led Clinic in
Cancer Care
Dr. Binu Babu
Asso. Professor
Mrs. Jincy Ealias
Assi. Professor

2. Learning objectives
• To be aware of how nurse led
clinics fit within the framework
of advanced nursing practice
• To determine the characteristics
of nurse led clinics
• Understand and promote the
value of nurse led services
relevance to cancer care

3. Nurse-led clinic
• Nurse-led clinic is an innovative idea in
health care delivery system, for patient
management by nurses.
• The International Council for Nurses (ICN)
reports, almost 70 countries across the
globe successfully implemented nurse
practitioner roles.

4. Nurse-led clinic
A nurse-led clinic is an
autonomous clinic
managed by registered
nurses, usually nurse
practitioners or Clinical
nurse specialists.

5. • Nurse practitioner programmes and
licentiate examination for nurses are among
the key initiatives under the National Health
Policy 2017 of the government of India.
• The government has already introduced an
amendment in the National Medical
Commission (NMC) Bill, a wide-ranging
legislation for reform in medicine, to allow
nurse practitioners to prescribe medicines.

6. Characteristics of nurse-led clinics
(Hill 1992)
• The provision of information and education
• Adopting an holistic approach not task
orientated
• The involvement of the multi-disciplinary team
• Providing symptom management
• Fostering patient participation.
• Monitoring of disease status
• Providing emotional support
• Patient education
• Management of stable disease
• Management of patients on biologic therapies.

7. Core clinical competencies
advanced practice
• Practicing autonomously
• Making decisions and being accountable
• Admitting and discharging patients
• Ability to take a clinical history
• Ability to physically examine patient
• Ability to determine diagnosis
• Ability to determine when onward referral is
required
• Ability to prescribe

8. Work pattern of nurse led clinic
The work pattern
of nurse led clinic
Identification of
Risk
Administration
of prescribed
treatment
Act as a link
between the
patient and
consultant
Health educator
Health check up
Symptom
management

9. Nurse led clinic in cancer care
• Nurse-led clinics are embedded in the
clinical pathway for patients during their
course of treatment - curative, adjuvant or
palliative.

10. Why a nurse led clinic in cancer
care???
Nurse led clinics focused to integrate the
pathway of care from acute to rehabilitative
phase, particularly for shortened hospital
stays and cost control.

11. The continuum of nurse led clinic
in cancer care
Basic
nursing
education
Specialty nursing
care education
Nurse
Practitioner
Nursing Care
Cancer Care
Nurse led
Cancer Care
Clinic

12. • Nurse led clinics can be run by a qualified
and specialty experienced nurse.
• A nurse who achieve the qualifications like
Post Basic Diploma in Oncology, Post
Graduation or Nurse Practitioner can lead a
nurse led clinics in cancer care.
• The treatments of cancer need more
accuracy hence specialty knowledge is
necessary to handle cancer patients.

13. Scope of nurse led clinic in
cancer care
Health education includes primary, secondary and
tertiary prevention
Individual
Health education Family
Society
Health education

14. • Teach the patient and family regarding the
disease condition, treatment need and plan.
• Recent advancements in cancer treatment
modalities such as chimeric antigen
receptor-T (CAR-T) cell therapy and
immune checkpoint inhibitors.

15. Risk identification
• Genetic & hereditary
factors
• Life style factors
• Occupation related
factors
• Habits

16. Cancer Screening
Oral examination
Breast examination
Testicular examination
Rectal examination
Cervical examination

17. Basic cancer care
Basic cancer care includes
the monitoring of vitals,
preparation of patient for
chemotherapy and surgery,
administration of prescribed
medications, preparations
for diagnosis etc.

18. Emergency care
• Identify the patients
health risk earlier and
provide life supportive
care then shift the
patient to tertiary care
centers or the
hospitals.

19. Chemo support
• Make necessary
arrangement and
administer prescribed
chemotherapy to the
patients. This will
reduces the patients
travel related issues
time, expenses and
increases their
adherence towards
treatment.
• Chemo port and CVAD
support.

20. Side effect management
• Timely care plays a
major role to control
side effects of cancer
treatments.

21. Lymphedema support
Identify different stages of
lymphedema and initiate
various preventive and
curative managements

22. Pain and Palliative
The aim of palliative
care is to reduce human
sufferings including
various symptom
management, pain
management,
psychological support.

23. Nutrition and dietetic
management
• Cancer patients
struggle to maintain
adequate nutrition due
to multiple reasons like
nausea, vomiting,
tastelessness, diarrhoea
etc.

24. Psycho-social support
• Psychological wellbeing is
vital in cancer treatment.
• Arrange peer meetings with
survivors to obtain positive
reinforcement.
• Help to obtain social
support in terms of financial
and treatment measures.

25. Rehabilitation
• Obtain maximum
functional level.

26. Research
• Identify the area of
research.
• Adequate documentation.
• Frequent review.
• Utilize data findings for
evidence based practice.

27. Collaboration with other
departments
• Focused on holistic care.
• Act as a link between
other health departments
and patient /family.
• Plan and collaborates
interventions of each
departments.

28. Benefits of nurse led clinic in
cancer care
• Improved patient outcomes
• Enhanced continuity of care
• Coordinated and collaborated care
• Professional autonomy
• Increased confidence
• Increased job satisfaction

29. Nurse led clinic in cancer care
settings
• Stoma care clinic
• Lymphoedema clinic
• Central Venous Access Devices (CVAD) clinic
• Head and Neck rehabilitation clinic

30. Conclusion
Novice
Advanced
beginner
Competent
Proficient
Expert
Broaden the scope of nursing
curriculum by competency based
modules and critical thinking
among nurses.

31. References
• Basavanthappa, B. T. (2014). Nursing
administration. Jaypee Brothers.
• Rowland, H. S., & Rowland, B. L.
(1997). Nursing administration handbook.
Aspen Publishers.
• Connie Henke Yarbro, Wujcik, D., & Barbara
Holmes Gobel. (2018). Cancer nursing :
principles and practice. Jones & Bartlett
Learning.